Rationale

Hematuria can be gross or microscopic. Although gross hematuria is often caused by a significant underlying pathology, both microscopic and gross hematuria require investigation.

Causal Conditions

(list not exhaustive)

1. Renal

   1. Glomerular disease (e.g., systemic lupus erythematosus, hemolytic uremic syndrome, vasculitis)

   2. Nonglomerular (e.g., acute interstitial nephritis, renal tumour, exercise)

2. Postrenal (e.g., stones, bladder tumour, benign prostatic hyperplasia, cystitis)

3. Hematologic (e.g., coagulopathy, sickle hemoglobinopathy)

4. Heme-negative red urine (e.g., medications, food)

Key Objectives

Given a patient with hematuria, the candidate will interpret a urinalysis, paying attention to differentiating glomerular from nonglomerular causes, and construct an initial management plan.

Enabling Objectives

Given a patient with hematuria, the candidate will

1. list and interpret clinical findings, including results of a detailed history and an appropriate physical examination;

2. list and interpret investigations, including a urinalysis and urine microscopy, as well as further laboratory and imaging studies as appropriate; and

3. construct an appropriate initial management plan, including appropriate follow-up and referral for specialized procedures as required (e.g., renal biopsy, cystoscopy).